Thromboembolic disease is a major cause of sudden death and catastrophic disability in Western societies. This grant will employ murine models of obesity to delineate underlying mechanisms. Preliminary Studies indicate that thrombi formed in ob/ob (leptin-deficient) and db/db (functional leptin receptor-deficient) mice in response to arterial injury (FeCI3) are unstable and frequently embolize. Administration of leptin stabilizes the thrombi formed in ob/ob but not in db/db mice, and promotes the aggregation of platelets from ob/ob but not db/db mice. The primary hypothesis of this grant is that leptin binds to its receptors on platelets, causing biochemical changes in platelet signaling and function that are necessary for thrombus stability. In Aim 1, bone marrow transplantation studies and leptin and leptin inhibitor (e.g., neutralizing antibodies) infusion studies, will be performed to determine the origin, target, and kinetics of action of the stabilizing leptin in thrombi, and to test the hypothesis that decrease in leptin will lead to the formation of unstable thrombi in wild-type mice. The mechanism(s) by which leptin promotes thrombus stability and enhances platelet activation will be studied in Aim 2. The possibility that leptin is required for optimal platelet: platelet and/or platelet vessel wall interactions will be examined, and the effects of leptin and leptin inhibitors on the aggregation, secretion and signaling of murine platelets will be determined. Preliminary Studies show that leptin potentiates the aggregation of human platelets from some donors but not from others. In Aim 3, the nature of the defect in non-responsive platelets (e.g., abnormalities in the leptin receptor) will be examined. The effects of leptin inhibitors on the aggregation of responsive and non-responsive platelets, and on the formation of stable "thrombi" will be tested. These studies will provide novel insights into the unexpected role of leptin in platelet function, and in the formation and stability of thrombi.